Weight and Body Shape Changes in a Treatment-Naive Population after 6 Months of Nevirapine-Based Generic Highly Active Antiretroviral Therapy in South India

The nutritional and body shape response after the initiation of highly active antiretroviral therapy (HAART) in resource-limited environments has not been documented. In this environment nutritional compromise is a common complication of human immunodeficiency virus (HIV) infection. We conducted a prospective study of 190 HIV-infected patients who initiated a nevirapine-based HAART regimen. CD4+ T cell count body weight body mass index anthropometry and bioelectrical impedance data were collected prior to initiation of therapy and after 6 months of therapy. The mean age of participants was 35 years 85% of participants were male and 59% received stavudine as 1 of the nucleosides in their initial HAART regimen. The members of the cohort were malnourished before the initiation of therapy and had a mean body mass index of 20.1 (calculated as weight in kilograms divided by the square of height in meters). Overall body weight increased a mean of 2.8 kg (range -12.5 to 22.5 kg) and CD4+ T cell counts increased by a mean of 140 cells/mm3. Patients were stratified into those who lost weight (loss of >1 kg 22%; n = 41) those whose weight remained stable (19%; n = 37) and those who gained weight (gain of >1 kg 59%; n = 112). Patients in all groups retained body shape symmetry and experienced no change in waist-to-hip ratio or regional body shape by anthropometry. The group that lost weight and the group whose weight remained stable experienced significant CD4+ T cell count increases at 6 months. Although the majority of HIV-infected patients who received nevirapine-based HAART gained weight there were participants who lost weight despite initiating their first HAART therapy. (authors)